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sis-�ao-oo2o City of Zephyrhilis Fire Fax-813-780-0021 <br /> Permit Application <br /> ate Received - Phone Contact for Permit �� � <br /> nvners Name � Owners Phone Number ��� a� 038/ I <br /> tivner'sAddress s�� C <br /> ee Simple Titleholder Name Titleholder Phone Number � � �� <br /> ee Simple Titleholder Address <br /> - ---- ' . - m . �� ,_r . ., . <br />�b Address �� <br /> Lot# <br /> ub Division Parcel# <br /> . .. .A._ ..,-,...m_ _._ . .., , ,..�. .w.� . .�,.x�..e, _. . ,, -� �. �, _.� ,� ... a �..�_��... _. -+�w.�z..-�. <br /> � Bio-Hazard Waste Storage-ANNUAL � Fumigation Tent p <br /> � Comm Exhaust Kitchen Hood/Duct � Hazardous Material(Tier II or RQ Facility�lNNUAL <br /> aControlled Bum a Hood Installation <br /> � Emergency Generator<30 kw � LP/Natural Gas-Installation �� <br /> � Emergency Generator>30 kw a LP/Naturai Gas-ANNU ale �' �� <br /> � Fire Protection Maintenance-ANNUAL � Places of Assembly-AN UAL � <br /> ��y emi �n er <br /> Sprinkler ❑ ❑ � � � Recreational8um ��—Y <br /> Fire Alartn � � ❑ ❑ �� � Sparklers <br /> Hood Cleaning � ❑ ❑ ❑ � � Sprinkler Syslem Installations <br /> Hood Suppression � ❑ ❑ ❑ � � Standpipes(Sprinkler Sys) <br /> � Fire Alarm Installation � Torch Roofing/Tar Kettle <br /> � Fire Pumps � Waste Tire Storage ANNUAL <br /> � Fire Works <br /> � Flammab�e Application-ANNUAL Valuation of Project <br /> � Fuel Tanks <br /> Q Other: <br />__ _ _r, ___.. ,._ � " �.. F L _.._ . ._r %'�'�p">i. � . q •. , ,- •�_'q::t . ...�-,ti -_,°.1. ".7;r. ,.fi,.s�a±�y> ., . .n�?'.¢.t „ <br /> .ad v,. �r <br /> ontractor <br /> Company <br /> ignature Registered Y/N Fee Current Y/N <br /> Addres License# <br /> LECTRICIAN Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Address License# <br />_UMBER <br /> Company <br /> gnature Registered Y/N Fee Current Y/N <br /> Address License# <br /> ECHANICAL Company • <br /> gnature Registered Y/N Fee Current Y/N <br /> Address License# <br /> fHER <br /> Company <br />�nature Registered Y/N Fee Current Y/N <br /> Address <br /> License# <br />�ections: <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized(Or,copy of signed contract with owner) <br /> If over$2500,a Notice of Commencement is required(Mechanical work over$5000) <br /> Supply two(2)sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel#-obtained from Property Tax Notice(http://appraiser.pascogov.com) <br />